Clinical efficacy and safety analysis of different treatment options for Cervical pregnancy

Objective: To compare the efficacy and safety of different treatment options for cervical pregnancy (CP). Materials and methods: A total of 74 patients diagnosed with CP at Hunan Provincial Maternal and Child Health Care Hospital between January 2016 and September 2022 were retrospectively analyzed. Among them, 31 were treated with uterine artery embolization (UAE) followed by hysteroscopic curettage, 34 were treated with hysteroscopic curettage alone, and nine were treated with high-intensity focused ultrasound (HIFU) followed by hysteroscopic curettage. Medical records and pregnancy outcomes were analyzed. Results: There were no significant differences in age, gravidity, parity, abortion, or preoperative hemoglobin levels among the patients in the three groups; however, significant differences in gestational age, gestational sac diameter, preoperative b-hCG, and presence of cardiac pulsation were observed (p< 0.05). After treatment, there was no conversion to laparotomy, and the uterus was preserved in all patients. Significant differences in blood loss during curettage, hospitalization costs, hospital days, menstrual recovery interval, b-hCG decline rates, retained products of conception, and intrauterine adhesions rate among the three groups were observed (p< 0.05). There were no significant differences in the placement of the uterine Foley balloon, effective curettage rate, preand postoperative hemoglobin decline, live birth rate, or proportion of subsequent pregnancies among the three groups. Conclusion: Our results showed that hysteroscopic curettage, HIFU, and UAE followed by hysteroscopic curettage are safe and effective for treating patients with CP. Compared with the UAE, HIFU has the advantages of lower hospitalization costs, shorter hospital stays, and shorter menstrual recovery intervals.